Author: Jack Slemenda Converse College, SC Date submitted to deafed.net – March 20, 2008 To contact the author for permission to use this PowerPoint, please.

Similar presentations

Presentation on theme: "Author: Jack Slemenda Converse College, SC Date submitted to deafed.net – March 20, 2008 To contact the author for permission to use this PowerPoint, please."— Presentation transcript:

1
Author: Jack Slemenda Converse College, SC Date submitted to deafed.net – March 20, 2008 To contact the author for permission to use this PowerPoint, please e-mail: slemenjc@spart5.k12.sc.us To use this PowerPoint presentation in its entirety, please give credit to the author.

4
All children have residual hearing that can be molded for functional use History and Philosophy of Auditory Verbal Therapy

5
What is AVT and where did it originate? AVT was established as an approach to therapy in the mid 20th century by pioneers Ling, Beebe, and Pollack. Auditory Verbal International established ten principles to guide the field and foster understanding of Auditory Verbal Therapy.

6
First AVT Principle Supporting and promoting programs for the early detection, identification, and diagnosis of hearing loss and the auditory management of infants, toddlers, and children identified along with Auditory-Verbal Therapy.

7
Second AVT Principle Providing the earliest and most appropriate use of medical and amplification technology to achieve the maximum auditory stimulation benefit.

8
Third AVT Principle Seeking to integrate listening as well as maximal acoustic stimulation into the childs total personality in response to the environment by guiding/coaching caregivers without the use of sign language or emphasis on speechreading.

9
Fourth AVT Principle Supporting the view that communication is a social act, and seeking to improve spoken communication interaction within the typical social dyad of infant/child with hearing loss and primary caregivers including use of the parents as primary models for spoken language development and implementing one-on-one teaching.

10
Fifth AVT Principle Seeking to establish the childs integrated auditory system for the self-monitoring of emerging speech.

12
Seventh AVT Principle Guiding and coaching parents to create environments that support listening/spoken language through the childs daily activities and to integrate listening and spoken language in the childs life.

14
Ninth AVT Principle Making ongoing informal/formal diagnostic evaluation and prognosis of the development of listening skills as an integral part of the rehabilitative process.

15
Tenth AVT Principle Supporting the concepts of mainstreaming and integration of children with hearing loss into regular education classes with appropriate support services and to the fullest extent possible.

17
Why AVT cont… When properly aided, children with hearing loss can detect most if not all the speech spectrum (Beebe, 1953;Goldstein, 1939; Johnson, 1976; Ling and Ling, 1978; Pollack, 1970, 1985; Ross and Calvort, 1984).

18
Cont…. Once all available residual hearing is accessed through amplification technology (eg. Binaural hearing aids and acoustically tuned earmolds, FM units, cochlear implants) in order to maximum detection on the speech spectrum, then a child will have the opportunity to develop language in a natural way through the auditory modality. A child with a hearing loss need not automatically be a visual learner. Hearing, rather than being a passive modality that receives information, can be the active agent of cognitive development (Boothroyd, 1982; Goldberg and Lebahn, 1990; Robertson and Flexor, 1990; Ross and Calvert, 1984).

19
Cont… In order to benefit from the critical periods of neurological and linguistic development, then the identification of hearing loss, use of appropriate amplification and medical technology, and stimulation of hearing must occur as early as possible (Clapton, and Winfield, 1976; Johnson and Newport, 1989; Lenneberg, 1967; Marler, 1970; Newport, 1990).

20
Cont…. If hearing is not accessed during the critical language years, a childs ability to use acoustic input meaningfully will deteriorate due to physiological (retrograde deterioration of auditory pathways), and psychosocial (attention, practice, learning) factors (Evans, Webster, and Cullen, 1983; Merzenich and Kass, 1982; Patchett, 1977; Robertson and Irvine, 1989; Webster, 1983).

21
Cont…. Current information about normal language development provides the framework and justification for the structure of Auditory-Verbal practice. That is infants/toddlers/children learn language most efficiently through consistent and continual meaningful interactions in a supportive environment with significant caretakers (Kretschmer and Kretscher, 1978; Lennenberg, 1967; Leonard, 1991; Ling, 1989; MacDonald and Gillette, 1989; Menyuk, 1977; Ross, 1990).

23
Rationale Cont… Parents in Auditory-Verbal programs do not have to learn sign language or Cued Speech. More than 90% of parents with children with hearing loss have normal hearing (Moores, 1987). Studies have shown that over 90% of parents with normal hearing do not learn sign language beyond the basic preschool level of competency (Luetke- Stahlman and Moeller, 1987). Auditory-Verbal Practice requires that caregivers interact with a child through spoken language and create a listening environment which helps a child to learn.

24
Cont… If a severe or profound hearing loss automatically makes an individual neurologically and functionally different from people with normal hearing (Furth, 1964; Myklebust and Brutton, 1953), then the Auditory-Verbal philosophy would not be tenable. The fact is however, that outcome studies show that individuals who have, since early childhood, been taught through the active use of amplified residual hearing, are indeed independent, speaking, and contributing members of mainstream society (Goldberg and Flexer, 1991; Ling, 1989, Yoshinaga-Itano and Pollack, 1988).

35
What to do if there is no sound? Battery may be dead Battery may be in backwards Hearing aid may be turned off Sound outlet may be plugged with ear wax

36
What to do if there is weak sound? Weak battery Sound outlet or inlet may be plugged with ear wax Current hearing condition may have changed

37
What to do if there is a crackling or frying sound? Volume may be set too high Object may be covering inlet such as a hat, scarf, or coat collar Excessive wax present in the ear Instrument may not be fitted correctly in the ear (contact audiologist)

44
Language Testing may include comprehensive language tests, such as the CELF-P2, CELF-4, PLS-4, CASL, CREVT-2,, TELD:3,TOLD-P:3, or TOLD-I:3. Tests of expressive language and vocabulary, such as, EOWPVT, EVT, SPELT-3 or SPELT-P.

45
Language Tests of receptive language, such as ROWPVT or PPVT-3. Screening tests: Rossetti Infant- Toddler Language Scale or the REEL- 3. Concept testing may also be completed, using a test such as the Bracken-R.

49
Chronological Age vs. Cochlear Age Chronological age begins at birth Cochlear age begins when the implant is activated Cochlear age used as tool Speech and language expectations/development should be based on cochlear age

50
Progression of Development Normal speech and language development can be expected on a delayed time scale Speech and language goals should follow the natural progression of normal speech and language development

53
Auditory Expectations with AVT & CA @ 24 months Identify a picture that is part of a simple story Identify an object with descriptors Recall 3 critical elements Answer questions about a picture, book, or set of objects

63
Auditory Strategies Move closer to the implant Vary the prosody and intonation Sing a song Put the key word at the end of the phrase Pause before saying the key word Whisper voiceless sounds Prolong fricatives and nasals /hausssss/ Repeat stops /kkkkeik/

64
Auditory Strategies Vary the number of syllables Decrease background noise Ask what did you hear? Auditory sandwich technique Present two choices Use the parent as a model

70
Language Goals and Activities 2 Year Old Jargon almost completely dropped out Pronouns are used often and correctly Vocabulary may have grown from 50-200 words Average sentence length 2.5 words

71
Language Goals and Activities 2 Year Old Vocabulary Understands 300-600 words Points to five body parts on command Responds to y/n questions appropriately Knows and uses prepositions in and on Names and produces sounds of common animals Follows simple directions

73
Language Goals and Activities 3 Year Old Talking in multi-word utterances Vocabulary is extensive and long Comprehensive of more complex directions Concrete in regard to subjects they can discuss The why question phenomenon

74
Language Goals and Activities 3 Year Old Vocabulary/Concepts Understand the meaning of Who?, Why? and How many? Able to answer AGENT + ACTION?s Knows own gender Understands basic adjectives big and little Counts up to 3 but only understand concept of one. Follows 2-4 part commands

75
Language Goals and Activities 3 Year Old Grammar Speaks in 3-4 word sentences Articles a the and copula/auxiliary is are beginning to be included. Use of word tense are present Use of pronouns I, me, you, my, mine Yes/no questions are developed Is this a horse? Over generalizes grammar rules

76
Language Goals and Activities 4 Year Old Begin to play with words Elaborates simple responses into long narratives Comments with approval on his/her own behavior and criticizes that of others

79
Language Goals and Activities 5 Year old Has a sense of social standards and limitations. (pragmatically appropriate given then situations) Mastered number concepts thru 10 Can name and describe use and function of everyday objects Grammatical and articulatory errors are eliminated

80
Language Goals and Activities 5 Year old Vocabulary Concepts Can group objects by category Aware of the function of senses (eyes, ears, nose, mouth) Understands prepositions behind and ahead of Understands first and last Understands the concept of time

81
Language Goals and Activities 5 Year old Grammar Sentences are from 5-6 words in length Can understand almost any type of sentence spoken Speaks in grammatically complete, correct sentences. Begins to develop metalinguistic awareness

84
Language Goals and Activities HOW DO I TEACH LANGUAGE?.... Language Teaching Hierarchy

85
Language Goals and Activities Language Temptations: **** Reminders: Do's Remember Children need opportunities to communicate Deal with the child in a sensitive way Be aware of the childs message Plan activities that mean something to the child through his or her daily activities Involve other people in the interaction Remember having fun is a part Allow wait time … typically 10-15 seconds; for those significantly impaired up to 30 seconds

86
Language Goals and Activities Dont s Dont rush the childs attempts to communicate Dont overload the childs ability to see, hear, and move. Dont set the child up to fail Dont waste valuable time doing things with child that will not help him or her in life Dont assume you know what the child is trying to communicate Expectations taken from Wetherby and Prizant 1989 Communicative Temptations and Pamela Talbot 2002 Topics in Auditory Verbal Therapy See Communicative Temptations Handout

87
Language Goals and Activities Handouts: See sampling of activities following phases 1-3 content categories of Bloom and Lahey. Note: Each activity can be modified to accommodate learners at varying phases of Bloom and Lahey.

88
Auditory Strategies Ask the child what did they hear; not are you listening??? Use the hand cue Move in closer Repeat whole phrase Acoustically highlight; not over-articulate Rephrase Whisper the key sound Model on the parent first